QUALITY MGMT SPEC II in Mount Laurel, NJ at Beacon Health Options

Date Posted: 4/14/2018

Job Snapshot

Job Description

About the Positon:

We are currently seeking a dynamic Quality Management Specialist II to join our team in Mt. Laurel, New Jersey. The Quality Management Specialist II  will be responsible for coordinating the planning, development, implementation, monitoring and analysis of quality management processes and activities.

Position Responsibilities:

  • Coordinates and manages key aspects of NCQA regulatory and customer reporting requirements including but not limited to:

•Knowledge of the standards/requirements

•Working with the team to meet or/ & exceed the standards

•Maintenance of necessary and relevant documentation history

•Completion NCQA and customer documentation requirements

•Knowledge and understanding of additional standards and regulations (Article 9 and URAC)

  • Conduct audits/internal assessments to ensure compliance with National and local policies, quality management activities, accreditation and regulatory standards.

  • Prepares professionally written assessment reports, internal document tracking and executive summaries that describe programs, methods, barriers, results, operational strengths, interventions, opportunities for improvement and recommendations.Ensures a comprehensive and analytic document.

  • Provide ongoing support for accreditation survey and customer audit preparation.

  • Assist in the oversight of organization-wide or engagement center-wide performance improvement

  • Participate in the development and implementation of policies and procedures. Periodically review and revise, as appropriate, QM policies and procedures.

  • Works closely with Clinical Operations, Customer Service, Account Management and Provider Relations at a local and corporate level to ensure comprehensive, efficiency and integrated systems that ensure communication and positive outcomes.

Position Requirements

Education:  Bachelor’s Degree (Relevant QM or Managed Care Exp.) required. Master’s Degree preferred

Licensures: CPHQ actively pursuing as defined as individual study and/or attending corporate study groups, sitting for exam and achieving certification within 3 years of the date of hire or appointment. Failure to successfully acquire the CPHQ will result in a demotion a QMS I position until successful completion of the exam.

Relevant Work Experience:

•License or MS with 3 years of UM or QM experience

•Non-licensed with 5 years of UM or QM experience

To Apply:

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled